Laparoscopic excision of large lower rectal gastrointestinal stromal tumour (GIST): A case report

Somu, Karthik; Dashore, Amit R; Shah, Aashish R.; Anandh, Rajiv

doi:10.4103/0972-9941.181311

Cited by 11 publications

(6 citation statements)

References 5 publications

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“…For large or low-lying rectal GISTs, radical excision may induce anal dysfunction with deleterious clinical consequences. Nowadays, transvaginal excision, a less-invasive approach, is preferable whenever feasible [2,10,11].…”

Section: Discussionmentioning

confidence: 99%

Transvaginal Excision of Rectal Gastrointestinal Stromal Tumor: A Safe Minimally Invasive Approach

Kaiyasah¹,

Fardan²,

Al-Ozaibi³

2021

Dubai Med J

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Introduction: Gastrointestinal stromal tumors (GISTs), the specific kit-positive mesenchymal tumors, are rarely found in the anorectum and account for 5% of all GIST cases. Surgical excision remains the main treatment for anorectal GIST. The available techniques include enucleation transanal excision or sometimes an abdominoperineal resection for large or low tumors. Case Study: We present a middle-aged female with a complaint of intermittent rectal pain for 1 year. Diagnostic workup detected a mass in the rectovaginal septum. A transvaginal excision was performed. Final histopathology showed rectal GIST. On regular follow-up visits, there was no detectable recurrence, and her anal pain disappeared completely. Discussion: Colorectal GIST accounts for only 0.1% of all colorectal tumors; this infrequency has led to a controversy in its diagnosis and management. Nevertheless, surgery remains a cornerstone element in the management of rectal GISTs. Different resection methods have been described in the literature, ranging from less-invasive approach such as transanal excision to a more radical one like an abdominoperineal resection. As there is no standard approach, choosing which one to perform depends on the tumor size, its location, and the surgeon’s preference. Conclusion: Transvaginal excision could be considered a safe minimally invasive approach for low-lying rectal GISTs.

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Section: Discussionmentioning

confidence: 99%

Transvaginal Excision of Rectal Gastrointestinal Stromal Tumor: A Safe Minimally Invasive Approach

Kaiyasah¹,

Fardan²,

Al-Ozaibi³

2021

Dubai Med J

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“…For large rectal GISTs or lower rectal GISTs, radical resection may induce severe anal dysfunction and discomfort. Currently, selecting different surgical procedures for minimally invasive surgery is widely accepted [11, 12]. Increasing research has shown that minimally invasive surgery, such as transanal endoscopic surgery, could reduce the rate of anal dysfunction [13, 14].…”

Section: Discussionmentioning

confidence: 99%

Transvaginal excision of rectal stromal tumors: case reports and a literature review

Wang

Liuyuan

et al. 2019

World J Surg Onc

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Background Gastrointestinal stromal tumors (GISTs) are the most common mesenchymal tumors of the gastrointestinal tract. Rectal locations are very rare, and minimally invasive surgery is a good choice for the treatment of rectal GISTs. Case presentation Two women each had a mass located on the lower vaginal-rectal space as determined by transvaginal ultrasound (TV-US), pelvis MR imaging, and colonoscopy. The patients successfully underwent transvaginal excision. The spindle-shaped cells were found in pathological test. The immunohistochemical analysis showed that CD117 and Dog-1 were stained positively. These results confirmed the masses as GISTs. The postoperative period was uneventful without anal dysfunction. Two patients were received adjuvant treatment with imatinib after surgery. Conclusion Transvaginal excision could be a minimally invasive and safe alternative treatment in the management of rectal GISTs in lower locations.

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“…The most common primary affected site is the stomach while esophagus, colon, and rectum are the rarest [ 12 ]. GISTs account for only 0.1% of cases of rectal tumors [ 15 ].…”

Section: Discussionmentioning

confidence: 99%

Subepithelial rectal gastrointestinal stromal tumor – the use of endoscopic ultrasound-guided fine needle aspiration to establish a definitive cytological diagnosis: a case report

et al. 2017

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BackgroundGastrointestinal stromal tumors are the most common mesenchymal neoplasms affecting the gastrointestinal tract. The stomach is the most common location to be affected, and the rectum one of the rarest, but the whole gastrointestinal tract remains susceptible. Gastrointestinal stromal tumors account for only 0.1% of rectal tumors. Currently, endoscopic ultrasound plays an essential role in the diagnostic process of gastrointestinal stromal tumors, especially when the affected sites have a worse outcome and higher morbidity rates.Case presentationWe describe the case of a 68-year-old white Japanese man with a history of long-term mild rectal pain and tenesmus. A digital rectal examination revealed a right palpable solid mass ranging from 3 to 7 cm from his anal verge. A colonoscopy was performed and showed a 5 cm elevated lesion covered by normal mucosa, located 4 cm above the pectineal line. Endoscopic ultrasound confirmed the diagnosis of a homogeneous hypoechoic mass with areas of necrosis as a rectal subepithelial lesion originating at the fourth layer (muscularis propria). He then underwent endoscopic ultrasound-guided fine needle aspiration of the lesion, followed by cytological and immunohistochemistry evaluation. The evaluation showed spindle and epithelioid cells of variable sizes, in fascicles separated by stroma, which reacted firmly and consistently to CD117/c-kit and CD34, and negative to desmin and S-100 protein. There was weak staining for nuclear Ki-67 in the tumor cells. A diagnosis of rectal gastrointestinal stromal tumor was confirmed. After a multidisciplinary meeting, an abdominoperineal resection of his rectum was performed. The pathology of the specimen confirmed the diagnosis of rectal gastrointestinal stromal tumor. He is now asymptomatic after 3 months’ follow-up and is on adjuvant therapy with a tyrosine-kinase inhibitor.ConclusionsGastrointestinal stromal tumors are rare tumors, and among the variety of primary location sites, the rectum is one of the rarest. The localization of this type of tumor has worse outcomes and higher morbidity rates. We report this rare case to emphasize the need for precise diagnosis and the important role of endoscopic ultrasound-guided fine needle aspiration in such situations.

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Laparoscopic excision of large lower rectal gastrointestinal stromal tumour (GIST): A case report

Cited by 11 publications

References 5 publications

Transvaginal Excision of Rectal Gastrointestinal Stromal Tumor: A Safe Minimally Invasive Approach

Transvaginal Excision of Rectal Gastrointestinal Stromal Tumor: A Safe Minimally Invasive Approach

Transvaginal excision of rectal stromal tumors: case reports and a literature review

Subepithelial rectal gastrointestinal stromal tumor – the use of endoscopic ultrasound-guided fine needle aspiration to establish a definitive cytological diagnosis: a case report

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